Key Issues

An electronic cigarette, or e-cigarette, is a cylindrical device made of stainless steel or plastic that mimics a cigarette in terms of its appearance and use and sometimes taste, but with a critical distinction—it does not contain tobacco.

The e-cigarette controversy comes down to two opposing views. Proponents believe that the e-cigarette represents a clean drug delivery device that can satisfy smokers’ addiction to both nicotine and smoking behaviours (the physical sensations of handling the cigarette and inhaling smoke) and thus greatly reduce their risk of disease and death. Proponents also emphasize that even though e-cigarettes may not have undergone rigorous scientific testing, they cannot be as harmful as cigarettes, since with cigarettes, it is the mode of nicotine delivery—the tobacco smoke—that is responsible for most of the disease not the tobacco itself or the nicotine in it.

Those opposed believe that e-cigarettes should be treated like other therapeutic products containing nicotine; that is, their sale should not be permitted until they have undergone clinical trials to prove their safety and their efficacy in helping smokers quit. Opponents fear that the widespread promotion and use of e-cigarettes will result in dual use (of electronic and real cigarettes)—rather than increased quitting—and will undermine efforts to denormalize smoking. Opponents are also concerned that as novelty gadgets with perceived low risk, e-cigarettes may be attractive to youth and may lead to nicotine addiction and subsequent tobacco use.